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Vaccine Hesitancy in Rural Southeastern United States
No full textPurpose: Minority populations in the United States (U.S.) have lower COVID-19 vaccination rates compared to the overall U.S. vaccination rates. COVID-19 vaccination rates in the United States are 81% for all races and ethnicities combined, while the vaccination rate for those identifying as Hispanic or Latino is 67%. This has not significantly improved from a 29% rate of vaccine hesitancy among those who identified as Hispanic in 2021. Community-engaged research has been found to be effective in identifying and understanding factors related to vaccine hesitancy and the broad reach of public libraries provides unique opportunities for outreach efforts to ameliorate health disparities.
Methods: We partnered with a local public library’s Hispanic Heritage event. The purpose of this project was to explore barriers, beliefs, and concerns of Hispanic, or Latino persons in a rural southeastern United States community about vaccinations. University IRB approval was obtained. We set up a table at the event and provided vaccine education and awareness via handouts in Spanish and English, as well as verbal information. Participants over the age of 18 years were invited to complete an 18-item survey including questions regarding whether they received COVID-19 vaccines, their opinion of COVID-19 safety, difficulty obtaining a vaccine, as well as general demographic information.
Results: Participants (n=153) completed a Qualtrics© survey. Results showed many (63%) felt getting a COVID-19 vaccine to protect them against COVID-19 was very important. Regarding how safe they thought a COVID-19 vaccine is, 30% felt it is completely safe, and 12% felt it is not at all safe. Regarding trust, 43% fully trust the healthcare providers who give/gave them a COVID-19 vaccine. If guessing about how many of their family and friends received a COVID-19 vaccine, 36% reported almost all, and 1% none. Regarding access, 65% reported it was not difficult to get the vaccine, with 76% reporting having received at least one dose of a COVID-19 vaccine. In response to how likely they are to get a COVID-19 vaccine in the future, 44% reported they would definitely not get a vaccine.
Conclusion: More activities are needed that 1) improve vaccination rates, 2) increase vaccine confidence and demand, and 3) address barriers and concerns. These activities must be culturally sensitive and appropriate and incorporate educational opportunities that can be readily accepted by this population
Pandemic Prevention Competencies of Long-Term Care Institution Workers: A National Survey in Taiwan
No full textAim: To assess the self-perceived pandemic prevention competencies of health and care workers in Taiwan’s long-term care institutions and identified key factors influencing these competencies.
Methods: A cross-sectional online survey was conducted from June to July 2024 using stratified proportional sampling of health and care workers (nursing and nursing assistants) from various types of long-term care institutions (assisted living facilities, residential care homes and nursing homes). Participants were actively employed during the survey, involved in COVID-19 prevention efforts, and proficient in reading traditional Chinese. Data on pandemic prevention competencies were collected, using the Emerging Infectious Disease Prevention Competencies Scale (EIDPCS). Other data collected included: participants\u27 demographics, and workplace characteristics.
Results: A total of 433 valid responses were obtained, representing residential care homes (n=269), nursing homes (n=125), and assisted living facilities (n=39). Participants generally rated their competencies as strong, with no significant differences between roles, and a mean score of 65.2 on the EIDPCS (range 40–81). Key predictors of competencies included a sense of purpose, perceived supervisor support, alignment with institutional culture, job satisfaction, and regular pandemic prevention drills.
Conclusion: Health and care workers in Taiwan’s long-term care institutions are generally competent in pandemic prevention but struggle with innovative problem-solving. Key predictors include a sense of purpose, supervisor recognition, job satisfaction, and regular drills. Institutional efforts and policy advocacy are crucial to enhancing preparedness
Using Photovoice to Teach Qualitative Research Methods
No full textTeaching undergraduate students qualitative research methods within the confines of a traditional didactic course can be challenging. Qualitative research is often very foreign and difficult to grasp as a concept comparatively to the more common quantitative research methodologies the students are exposed to in several of their pre-nursing courses. This poster presentation demonstrates the use of Photovoice as a teaching method to teach qualitative research methods. This activity gives the students the experience of being both subjects in and researchers of a qualitative study. The use of photography to express oneself has become common place in the age of social media. Photovice is a form of participatory action research methodology. It is used to create awareness of a marginalized group and creating a narrative of picture and words the lived experiences to create change. Photovoice engages participants as co-researchers along with the qualitative researcher to develop the final presentation. In the course activity created by the author, students submitted their photo and caption that answered the faculty member\u27s question as a class assignment. The faculty then aggregated the de-identified photos and captions and provided packets of the photos/narratives to several small groups of students during class time. The groups then utilized the class period to discuss and categorize the pictures/narratives into codes and then grouping codes into 2-4 themes. Small groups then practiced triangulation with the other groups and made adjustments. Final report outs with selection of exemplars covered credibility and dissemination concepts of qualitative research
A Strategic Leadership Approach to Build an Innovative Culture through EBP, QI, and Research
No full textBackground: Healthcare organizations face mounting pressure to improve patient outcomes while reducing costs in a rapidly changing environment. Strong leadership is essential to foster a culture of inquiry and innovation that drives evidence-based practice (EBP), quality improvement (QI), and research. However, barriers such as resource limitations, risk aversion among managers, and a lack of clear frameworks for frontline staff can impede these efforts. This initiative addressed these challenges by empowering nurses at all levels to engage in scholarly activity and lead improvement efforts.
Methods: A team of three nurse leaders within a 12-hospital system developed a comprehensive program including toolkits, training modules, and a structured mentorship program. This program provided a structured approach to address potential concerns regarding job security and support for innovation, which can commonly arise during periods of change. The program utilized an enhanced process improvement model, adapted from the Institute of Healthcare Improvement, Lean, and Six Sigma methodologies, to strengthen root cause analysis and guide QI initiatives, providing guardrails to ensure project quality and allay leadership concerns.
Results: Over two years, the program resulted in a 400% increase in system-wide QI initiatives, 63 research studies, 210 EBP projects, 374 projects initiated from shared governance, and 25 national/international presentations. These initiatives led to significant improvements in patient outcomes, including decreased length-of-stay, reduction in HAPIs, and improved patient satisfaction. Cost savings were substantial, with an annual ROI ranging from 63% to 79.5% on projects such as CAUTI, CLABSI, and mortality reduction. The program also improved nurse retention and reduced dependence on travelers.
Conclusion: This program demonstrates that a strategic leadership initiative focused on nurse empowerment and mentorship can effectively cultivate a culture of inquiry and innovation within a dynamic healthcare environment. By providing the necessary resources, support, and a structured framework, healthcare organizations can achieve significant improvements in patient care, cost savings, and nurse engagement. This model, developed by a small team, offers valuable and accessible insights for healthcare systems of all sizes seeking to develop future nurse leaders and drive organizational excellence
Assessment of Cultural Competence of Nursing Faculty
No full textIntroduction: Nurses’ cultural competence is vital in improving patients’ experiences and reducing health disparities. Cultural competence should be integrated into nursing curricula to prepare nursing students to deliver culturally competent care. Unfortunately, not all nursing educational practices are culturally competent. Institutions and agencies for advancing nursing education have acknowledged the importance of cultural competence in nursing education. Few studies have critically examined nurse faculty readiness and preparation in cultural competence in the United States. Therefore, we aimed to assess cultural competence among nurse faculty at a large nursing school in the Southwestern United States.
Methods: Using convenience sampling, a cross-sectional, descriptive quality improvement project was conducted among 41 nursing faculty participants. A demographic and professional characteristics questionnaire and the Cultural Diversity Questionnaire for Nurse Educators–Revised were administered. Faculty were also asked to respond to open-ended questions about activities or topics they used to teach or measure students’ cultural competence or to improve their own. Data were analyzed using descriptive and inferential statistics.
Results: The overall cultural competence score (mean=154.9; SD=23.8) indicated high levels of cultural competence of nursing faculty. Participants scored highest per item on the Cultural Awareness Subscale (mean=4.0; SD=0.7) and lowest on the Cultural Skills Subscale (mean=3.5, SD=0.8). Cultural competence scores were significantly associated with presentation of cultural content in the course (F=6, p=0.006); those who fully integrated cultural content had significantly higher cultural competence (174.3) than those who occasionally integrated cultural content (153.5) and those who merely included a cultural activity (121.3). Qualitative analysis of the open-ended questions revealed inconsistency of integration of cultural content.
Discussion: These findings can be used to prepare faculty to educate nursing students to deliver culturally competent care potentially reduce healthcare disparities, and improve patient outcomes. Nurses\u27 cultural competence can be developed by offering multicultural nursing education, increasing direct/indirect multicultural experiences, and sharing problem-solving experiences to promote nurses’ coping abilities
Global Advocacy Academy: Preparing Nurses for Engagement at the United Nations and Beyond
No full textBackground: As global citizens and informed healthcare leaders, nurses are key to addressing global health challenges and are uniquely positioned to advocate for vulnerable populations worldwide. This presentation shares a successful model for preparing nurses with advocacy skills to improve global health outcomes by fostering collaboration among healthcare stakeholders.
Methods: The six-week virtual academy, led by former Liaisons to the United Nations (UN), is designed to equip nurses with the knowledge, skills, and abilities to contribute to good health and well-being for all through global advocacy efforts. Participants gain insights into nursing organization consultative status with the UN, their own role in advancing the Sustainable Development Goals (SDGs), and how every nurse can contribute to global impact. Through interactive experiences, participants acquire practical knowledge applicable to healthcare and policy advocacy, both locally and globally.Results: To date, 163 nurses have completed the academy. After completing the academy, the majority (97%) of those that completed the evaluation (n=94) agreed that they were well-informed about the SDGs and 96% planned to increase their participation in advancing them. Most (95%) felt they could identify strategies to become more engaged in addressing global health problems and (90%) reported they were better prepared to actively participate on the global stage. Several academy graduates have addressed key stakeholders in global health forums.
Conclusions: The Global Advocacy Academy is an effective model to prepare nurses as influential advocates in advancing global health. Nurse leaders can encourage participation in the academy and use this framework to replicate advocacy development strategies in their own organizations
Improving HIV Knowledge and Attitudes of the Youth in the Philippines Through Mobile Text Messaging
No full textBackground: The Philippines has the highest HIV incidence rate in the Asia-Pacific region, with the highest incidence between the ages 15 to 34 years. There are low levels of HIV knowledge, negative attitudes towards people with HIV/AIDS, and a lack of interventional studies to improve HIV knowledge and attitudes in the country. The high rate of mobile phone use and text messaging in the Philippines offers potential in using technology to address gaps in HIV knowledge and negative attitudes regarding HIV.Purpose: This pilot study determined the feasibility and effectiveness of mobile text messaging (MTM) in improving HIV/AIDS knowledge and attitudes among adolescents and young adults in the Philippines. It addressed Sustainable Development Goal 3 target on ending the HIV epidemic.Methods: This study used a quasi-experimental design. Ninety-four participants from two provinces in the Philippines with a rapidly increasing HIV incidence rate participated in a 20-day MTM in July 2024. The HIV Knowledge Questionnaire and AIDS Attitude Scale assessed HIV/AIDS knowledge and attitudes, respectively, before and after MTM. Independent t-test and analysis of variance were used to determine mean differences in HIV knowledge and attitudes among groups of participants. Dependent t-test was used to assess the effectiveness of MTM.Results: There was a statistically significant increase in HIV knowledge post-MTM (M = 30.6, SD = 8.90) compared to pre-MTM (M = 22.7, SD = 10.7), t(141) = -4.56, p = \u3c.001. A significant increase in HIV attitude scores was observed post-MTM (M = 95.3, SD = 14.7) compared to pre-MTM (M = 88.1, SD = 16.3), t(141) = -2.64, p = .004. Participants who identified themselves as homosexual/bisexual (p=.004), discussed HIV/AIDS with peers (p=.004) and partners (p=.002), answered using the English version of the research instruments (p=\u3c.001), and those who had higher income (p=.006) had significantly higher levels of HIV/knowledge. Significant differences in HIV/AIDS attitudes were seen across sexual orientation (p=\u3c.001) and discussions with peers (p=\u3c.001) and partners (p=.01).Conclusion: MTM is effective in improving HIV/AIDS knowledge and attitudes. The results of this study can be used in designing evidence-based public health interventions to address specific knowledge gaps and negative attitudes toward HIV/AIDS
Cardiovascular Awareness, Risk Factors Awareness, and Select Risk Reduction Interventions
No full textCardiovascular disease (CVD) remains the leading cause of death globally. African American (AA) females experience a disproportionately higher burden of CVD risk factors compared to other racial and gender-ethnic groups. This disparity in CVD risk is particularly pronounced among premenopausal and middle-aged AA females. While CVD is primarily preventable, addressing social determinants of health (SDOH) and achieving equitable health requires a comprehensive understanding of the factors influencing CVD risk and health behaviors.
This descriptive correlational study employed a secondary data analysis using the 2020 National Health Interview Survey (NHIS) dataset to examine the relationships among CVD awareness, modifiable risk factor awareness, clinician cues to action, and preventative lifestyle behaviors among middle-aged AA women (n = 962, ages 35-64 years) and the role of education as a moderator of CVD risk factors and healthy lifestyle behavior. Preventative lifestyle behaviors were defined either as healthy lifestyle behaviors (physical activity and BMI \u3c30) or lifestyle behavior modification (increasing exercise, reducing fat/calories, participating in a weight loss program). Logistic regression analyses simultaneously controlled for SDOH: food/economic stability, social support, healthcare access, neighborhood, and education. The sub-analysis explored relationships between favorable SDOH and physical activity and between clinician cues to action and lifestyle behavior modification for obese and non-physically active females.
Results revealed significant relationships between CVD awareness, CVD modifiable risk factor awareness, clinician cues to action, and the adoption of preventative lifestyle behaviors but failed to observe a significant moderating effect of education on the relationship between CVD risk factor awareness and healthy lifestyle behaviors. Favorable SDOH were associated with active engagement in physical activity.
This study underscores the complex relationship of factors influencing CVD preventative behaviors and demonstrates that awareness of CVD and risk factors alone may not be sufficient to promote behavior change. The critical role of clinician influence to promote lifestyle behavior modifications among this high-risk population is highlighted. Together, these findings suggest the need for tailored interventions addressing individual and social factors to improve CVD outcomes in AA middle-aged females
Are You Ready to Escape? Representing Innovation Through Escape Room Pedagogy in Obstetric Education
No full textFacilitating quality clinical experiences for students is a significant challenge in nursing education. Nursing students must develop critical thinking and collaborative skills to ensure safe, effective patient care. To foster these competencies, an innovative escape room pedagogy was introduced as an alternative to traditional simulation experiences. This interactive approach engages students in teamwork, problem-solving, and clinical judgment within a dynamic and enjoyable learning environment. By integrating escape rooms into the curriculum, nursing programs can better prepare students for real-world clinical challenges, improving patient care and addressing health disparities.
This study also aimed to determine the feasibility of integrating escape rooms into undergraduate nursing curricula as a preparation tool for the Next Generation Nursing (NGN) licensure exam. By aligning with the Clinical Judgment Measurement Model (CJMM), escape rooms simulate real-life scenarios that facilitate competency development and readiness for NGN testing standards.
The escape room was developed through a structured process:
Plan: Identified topics and resources aligned with clinical and NGN competencies.Build: Designed puzzles, prepared materials, and created a training handbook.Implement: Conducted orientations and guided students through scenarios.Evaluate: Gathered feedback through surveys and conducted debriefings.The study involved 120 Bachelor of Science in Nursing (BSN) students. Small groups of 4–5 rotated through three escape rooms simulating obstetric emergencies, with clinical faculty overseeing activities. Data collection included pre- and post-tests assessing knowledge, anxiety, and self-confidence, and feedback via the Clinical Simulation Completion Questionnaire. Although anxiety and self-confidence outcomes were not statistically significant, students reported heightened engagement, improved critical thinking, and a preference for more escape room activities.
Evaluation forms documented faculty observations and recommendations. Students highlighted the safe, supportive environment for practicing skills critical for bedside care. Despite being limited to one institution, the findings suggest escape rooms can enhance clinical competencies. Future research across diverse nursing programs could provide broader insights into their role in NGN readiness and competency-based education
Health Management Self-Efficacy
No full textMinority populations, such as Black adults of non-Latinx descent, are more likely to develop chronic diseases and complications related to disease severity when compared to non-Latinx Whites (NLW). Furthermore, Black adults of non-Latinx descent people are less likely to engage in and maintain health-promoting behaviors (HPB) to prevent disease development. HPB are effective in preventing or delaying chronic disease. This research explores the relative impact of aspects of health, built environment, and key demographic domains on the health management self-efficacy (HMSE) of a national sample of Black adults.
Methods: Hierarchical regression modeling was performed utilizing data from the 2018 National Survey of Health Attitudes to investigate the relative impact of aspects of health, built environment, and key demographic domains on HMSE of a national sample of Black adults. Moreover, to better understand the unique role of gender, analysis was performed initially for the entire sample and then separately for males and females.
Results: When controlling for all other variables, HMSE in all Black adults of non-Latinx descent was significantly correlated with various built environment- and key demographic-level variables. Significant gender differences were identified between men and women in all three domains.
Conclusions: This study reveals the variables that significantly impact the HMSE of Black adult men and women of non-Latinx descent. The findings of this study can help develop HMSE and the adoption of HPB and reduction of chronic illness in Black men of non-Latinx descent and Black of non-Latinx descent women